Upper GI endoscopy with biopsy at Holy Cross Hospital - Salt Lake. CPT 43239.
What Holy Cross Hospital - Salt Lake publishes for this service, straight from its standard-charges file, last updated February 11, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$110–$864range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Denver Health | Managed Medicaid | $110 |
| Health Choice | Managed Medicaid | $110 |
| Medicaid | Managed Medicaid | $110 |
| Rocky Mountain Health Plan | Managed Medicaid | $110 |
| UUHP | Managed Medicaid | $110 |
| Humana | Managed Medicare | $126 |
| Medicare | Managed Medicare | $126 |
| Medicare | Medicare | $126 |
| Employer Direct Healthcare | Commercial PPO/POS/HMO | $159 |
| MotivHealth | Commercial PPO/POS/HMO | $168 |
| Molina | Commercial PPO/POS/HMO | $273 |
| Regence Blue Cross Blue Shield | Commercial PAR | $864 |
| Regence Blue Cross Blue Shield | Commercial PPO | $864 |
| Regence Blue Cross Blue Shield | Commercial Savewell | $864 |
| Regence Blue Cross Blue Shield | Commercial UVU | $864 |
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